MEDICARE: VIRGINIA FAY HONAKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	800237818	OTHER	WV	STUDENT

General Provider Information

NPI Number	:	1275146540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA FAY HONAKER

Provider Business Mailing Address
First Line	:	5000 STATION ST APT 1012
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26508-7442
Country	:	US
Telephone Number	:	210-979-1496
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 STATION ST APT 1012
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26508-7442
Country	:	US
Telephone Number	:	210-979-1496
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

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Directions to “ VIRGINIA FAY HONAKER ” Practice Location

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